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Akbari MR, Alghurab A, Khorrami-Nejad M, Azizi E, Masoomian B. Sensory exotropia versus sensory esotropia: A comparative clinical features study. JOURNAL OF OPTOMETRY 2024; 17:100516. [PMID: 38663271 PMCID: PMC11064616 DOI: 10.1016/j.optom.2024.100516] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/30/2023] [Revised: 02/15/2024] [Accepted: 03/08/2024] [Indexed: 05/05/2024]
Abstract
PURPOSE This study aimed to compare the preoperative clinical features of patients with sensory esotropia (ET) and sensory exotropia (XT). METHODS In a retrospective study, the medical records of 13,252 patients who underwent strabismus surgery were reviewed at the Farabi Eye Hospital, Iran, from 2012 to March 2022. There were 1017 patients with sensory horizontal strabismus whose, in their worse eye, had corrected distance visual acuity (CDVA) equal to or <20/160 tested with the Snellen chart. RESULTS The mean age of patients was 29.0 ± 12.4 years [574 (56.4%) males and 443 (43.6%) females]. Sensory XT and ET were observed in 717 (70.5%) and 300 (29.5%) patients, respectively (P<.001). The mean CDVA in the strabismic and non-strabismic eyes was 1.40 ± 0.75 and 0.05 ± 0.13, respectively (P<.001). Also, the CDVA in the strabismic eyes was significantly worse in the patients with sensory XT than in the patients with sensory ET (P<.001). Sphere and spherical equivalent (SE) components were more hyperopic in both eyes of patients with sensory ET than sensory XT (P<.001). In sensory ET group, the mean horizontal deviation at far and near was significantly higher than the sensory XT group (both P<.001). The prevalence of moderate and severe amblyopia among all patients with sensory strabismus was 274 (26.9%) and 727 (71.5%), respectively (P<.001). There were 398 (39.1%) patients who needed more than one surgery. CONCLUSION The frequency of sensory XT was about 2.5 times more than the sensory ET. Most patients with sensory ET were operated at a younger age, had better CDVA, more hyperopic spherical and SE, and higher angle of deviation compared with patients with sensory XT. The chance of reoperation in patients with sensory strabismus was about 40%.
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Affiliation(s)
- Mohammad Reza Akbari
- Translational Ophthalmology Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Alaa Alghurab
- Optometry Department, School of Rehabilitation, Tehran University of Medical Sciences, Tehran, Iran
| | - Masoud Khorrami-Nejad
- Translational Ophthalmology Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran; Optometry Department, School of Rehabilitation, Tehran University of Medical Sciences, Tehran, Iran.
| | - Elham Azizi
- Mashhad University of Medical Sciences, Mashhad, Iran
| | - Babak Masoomian
- Translational Ophthalmology Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran
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Palani S, Baskaran AA, Rinita D. Optical coherence tomography predictors of the outcomes of occlusion therapy in anisometropic amblyopia. Oman J Ophthalmol 2023; 16:281-286. [PMID: 37602148 PMCID: PMC10433063 DOI: 10.4103/ojo.ojo_355_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Revised: 12/28/2022] [Accepted: 03/29/2023] [Indexed: 08/22/2023] Open
Abstract
AIM (1) To compare optical coherence tomography (OCT) parameters between amblyopic eyes and fellow eyes in patients presenting with anisometropic amblyopia. (2) To find OCT factors predicting the outcomes of occlusion therapy. MATERIALS AND METHODS This prospective study was conducted in a tertiary eye care center for a period of 20 months. Fifty-four children diagnosed with anisometropic amblyopic were included in the study. After complete ophthalmic and OCT examination, patients were advised to undergo occlusion therapy with large spectacle patch. Patients were reviewed after 6 months to record improvement in visual acuity and analyze their OCT parameters. Statistical tests used were paired "t" test and independent "t" test. RESULTS The mean age of 54 study patients was 9.24 ± 2.82 years. For comparison of OCT parameters, they were classified as myopic (22 patients), hypermetropic (24 patients), and astigmatic (8 patients) groups. In the anisomyopic amblyopia group, the mean inner macular thickness was significantly increased in fellow eyes (304.09 ± 11.06 μm) compared to amblyopic eyes (297.59 ± 14.16 μm). In the anisohyperopic amblyopia group, the outer macular thickness significantly increased in amblyopic eyes (286.43 ± 18.63 μm) when compared to fellow eyes (272.62 ± 14.90 μm). In the follow-up visit, 28 patients showed improvement and 6 patients did not show improvement in final best-corrected visual acuity, and the OCT parameters in amblyopic eyes of these two groups did not differ significantly. CONCLUSION Abnormal experience in early life does not affect the maturation process of retinal layers as evident by OCT parameters, and these parameters cannot predict the outcomes of occlusion therapy.
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Affiliation(s)
- Subashree Palani
- Department of Ophthalmology, Karpaga Vinayaga Institute of Medical Sciences and Research Centre, Madurantakam, Tamil Nadu, India
| | | | - Deborah Rinita
- Department of Ophthalmology, Shri Sathya Sai Medical College and Research Institute, Sri Balaji Vidyapeeth, Ammapettai, Tamil Nadu, India
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Magli A, Esposito Veneruso P, Rinaldi M, Caputo R, Tranfa F, Costagliola C. Long-term effects of early/late-onset visual deprivation on macular and retinal nerve fibers layer structure: A pilot study. PLoS One 2023; 18:e0283423. [PMID: 36952524 PMCID: PMC10035877 DOI: 10.1371/journal.pone.0283423] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2022] [Accepted: 03/08/2023] [Indexed: 03/25/2023] Open
Abstract
BACKGROUND/AIMS Tomographic analysis of macular and peripapillary retinal nerve fibers layer (RNFL) thickness in patients with history of congenital (CC) and developmental cataract (DC). METHODS Analysis of macular and RNFL thickness using a spectral-domain optical coherence tomography was performed. Retinal layers thickness was measured using the internal segmentation software. Measurements of affected (unilateral and bilateral), contralateral eyes and control eyes were compared. RESULTS Patients with history of CC or DC (n = 13 and 11 respectively) and 35 healthy control subjects were enrolled. Thicker inner and outer nuclear layers (INL, ONL) and thicker ONL were found when CC and DC group when compared to controls respectively. Bilateral CC showed the most relevant differences. Slight thickening of CC inner retinal layers were found when compared to DC. Increased superonasal RNFL thickness was found in CC group when compared to DC and controls. Thickening of RNFL of contralateral unaffected eyes of unilateral CC were found when compared to controls. CONCLUSION Significant macular and RNFL thickness changes between CC, DC patients and controls that partially involve also contralateral unaffected eyes of unilateral congenital cataract were found. CC and DC groups show significant differences only in inner retinal layers thickness. Our data suggest that early visual deprivation may influence retinal arrangements occurring during development involving predominantly the outer nuclear layer and para/perifoveal inner retinal layers, and confirm that early treatment of CC allow to achieve better long-term visual outcome. Moreover functional and structural data support the hypothesis that unilateral amblyopia is not exclusively an unilateral issue.
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Affiliation(s)
- Adriano Magli
- Department of Ophthalmology, Orthoptic and Pediatric Ophthalmology, University of Salerno, Salerno, Italy
| | | | - Michele Rinaldi
- Pediatric Ophthalmology Unit, A. Meyer Children's Hospital, Florence, Italy
| | - Roberto Caputo
- Eye Clinic, Multidisciplinary Department of Medical, Surgical and Dental Sciences, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Fausto Tranfa
- Department of Neurosciences, Reproductive and Odontostomatological Sciences, University of Naples Federico II, Naples, Italy
| | - Ciro Costagliola
- Department of Neurosciences, Reproductive and Odontostomatological Sciences, University of Naples Federico II, Naples, Italy
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Na JH, Lee SJ. Interocular differences in subfoveal choroidal thickness in monocular intermittent exotropia. J AAPOS 2022; 26:127.e1-127.e5. [PMID: 35525387 DOI: 10.1016/j.jaapos.2021.12.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2021] [Revised: 11/12/2021] [Accepted: 12/20/2021] [Indexed: 11/17/2022]
Abstract
PURPOSE To determine whether subfoveal choroidal thickness and central foveal thickness differ according to the presence of fixation preference in patients with intermittent exotropia without anisometropia or amblyopia. METHODS Children ≥4 years of age with either monocular (fixation preference) or alternating intermittent exotropia on three consecutive visits who had no anisometropia, no amblyopia, and spherical equivalent of ± 1.25 D or less in both eyes were recruited for this study. Subfoveal choroidal thickness and central foveal thickness, measured using spectral domain optical coherence tomography, in the monocular group and the alternating group were compared. RESULTS A total of 81 patients were enrolled: 46 in the monocular exotropia group and 35 in the alternating exotropia group. The interocular difference in subfoveal choroidal thickness was -11.0 ± 18.0 μm in the monocular group (dominant eye - nondominant eye) and 1.9 ± 22.2 μm in the alternating group (right eye - left eye). The difference between groups was statistically significant (P = 0.005). The interocular difference in central foveal thickness was 1.1 ± 5.7 μm in the monocular group (dominant eye - nondominant eye) and 0.9 ± 5.0 μm in the alternating group (right eye - left eye). The difference between groups was not significant. CONCLUSIONS In patients with intermittent exotropia without amblyopia, the difference in subfoveal choroidal thickness between the eyes in the monocular group was significantly greater than that between eyes in the alternating group. These findings suggest the presence or absence of fixation preference may affect subfoveal choroidal thickness.
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Affiliation(s)
- Jeong Ho Na
- Department of Ophthalmology, Haeundae Paik Hospital, Inje University College of Medicine, Busan, Korea
| | - Soo Jung Lee
- Department of Ophthalmology, Haeundae Paik Hospital, Inje University College of Medicine, Busan, Korea.
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Karabulut M, Karabulut S, Sül S, Karalezli A. Microvascular differences in amblyopic subgroups: An observational case-control study. Eur J Ophthalmol 2021; 32:11206721211065852. [PMID: 34859717 DOI: 10.1177/11206721211065852] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
PURPOSE To determine retinal microvascular differences among amblyopic subgroups and compare them with control eyes. STUDY DESIGN This study was designed as an observational case-control study. METHODS Twenty-three strabismic, 23 anisometropic, 22 meridional, 22 ametropic amblyopic eyes, and 24 healthy control eyes were included. The mean vessel densities in the deep and superficial capillary plexus, the foveal avascular zone area, the choriocapillaris flow area, and the foveal thickness were compared. RESULTS Vessel density was markedly lower in all sectors of the amblyopic subgroups in the deep capillary plexus than in control eyes. Density was significantly lower in the superficial capillary plexus only in ametropic and meridional amblyopic eyes. Among these groups, the meridional amblyopic eyes had the largest choriocapillaris flow area (p = 0.013) and the lowest vessel density in all sectors (p < 0.001). The foveal avascular zone area was similar in all groups (p = 0.561). The fovea was significantly thicker only in the anisometropic and meridional subgroups than control eyes (p = 0.011, p = 0.001, respectively). The foveal avascular zone area was inversely related to the foveal thickness in all groups. CONCLUSION Retinal structural and microvascular differences were found among amblyopic subgroups. Optical coherence tomography angiography can noninvasively detect these variations, which may be related to the etiologic factors.
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Affiliation(s)
- Müjdat Karabulut
- 52986Mugla Sıtkı Koçman University Medical School, Department of Ophthalmology, Mugla, Turkey
| | - Sinem Karabulut
- 52986Mugla Sıtkı Koçman University Medical School, Department of Ophthalmology, Mugla, Turkey
| | - Sabahattin Sül
- 52986Mugla Sıtkı Koçman University Medical School, Department of Ophthalmology, Mugla, Turkey
| | - Aylin Karalezli
- 52986Mugla Sıtkı Koçman University Medical School, Department of Ophthalmology, Mugla, Turkey
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Masri OS, Abiad B, Darwich MJ, Sarkis PA, El Mollayess GM, Nasser Z, Fares Y, Al Ahmar E, Estephan E. Morphological changes in amblyopic eyes in choriocapillaris and Sattler's layer in comparison to healthy eyes, and in retinal nerve fiber layer in comparison to fellow eyes through quantification of mean reflectivity: A pilot study. PLoS One 2021; 16:e0255735. [PMID: 34358257 PMCID: PMC8345865 DOI: 10.1371/journal.pone.0255735] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2021] [Accepted: 07/22/2021] [Indexed: 11/25/2022] Open
Abstract
Purpose Establishing the reliability of a new method to check the mean retinal and choroidal reflectivity and using it to find retinal and choroid changes in amblyopia. Methods Design: Retrospective case-control. Population: 28 subjects of which 10 were healthy controls (20 eyes): 8 with refractive errors, 1 with strabismus, and 1 with both. 18 patients with unilateral amblyopia included: 7 anisometropic, 6 isoametropic, 1 strabismic, and 4 combined. Mean participants’ age: 13.77 years ± 10.28. Observation procedures: SD-OCT and ImageJ. Main outcome measure: mean reflectivity of retinal and choroid layers. Amblyopic, fellow, and healthy eyes were compared. Results The method of measuring reflectivity is good to excellent reliability for all regions of interest except the fourth. The mean reflectivity of the choriocapillaris and Sattler’s layer in amblyopic eyes were significantly lower than in healthy eyes (p = 0.003 and p = 0.008 respectively). The RNFL reflectivity was lower than that of fellow eyes (p = 0.025). Post-hoc pairwise comparisons showed statistically significant differences between amblyopic and healthy eyes for choriocapillaris (p = 0.018) and Sattler’s (p = 0.035), and between amblyopic and fellow eyes for RNFL (p = 0.039). Conclusion A decrease in reflectivity of the choriocapillaris and Sattler’s in amblyopic compared to healthy eyes, and a decrease in reflectivity of the RNFL in the amblyopic compared to fellow eyes, indicate that the pathophysiology is partly peripheral and might be bilateral.
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Affiliation(s)
- Oussama Samer Masri
- Faculty of Medical Sciences, Neuroscience Research Center, Lebanese University, Beirut, Lebanon
| | - Bachir Abiad
- Ophthalmology Department, Monla Hospital, Tripoli, Lebanon
| | | | | | | | - Zeina Nasser
- Faculty of Medical Sciences, Neuroscience Research Center, Lebanese University, Beirut, Lebanon
| | - Youssef Fares
- Faculty of Medical Sciences, Neuroscience Research Center, Lebanese University, Beirut, Lebanon
| | - Elie Al Ahmar
- Faculty of Arts and Sciences, Holy Spirit University of Kaslik, Kaslik, Lebanon
- School of Engineering, Holy Spirit University of Kaslik, Kaslik, Lebanon
| | - Elias Estephan
- Faculty of Medical Sciences, Neuroscience Research Center, Lebanese University, Beirut, Lebanon
- Faculty of Arts and Sciences, Holy Spirit University of Kaslik, Kaslik, Lebanon
- * E-mail:
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Bayraktar Z, Pehlivanoglu S, Bayraktar S, Albayrak S, Karakaya M. Inter-Ocular Symmetry of Vascular Density and Retinal Thickness in Unilateral Anisometropic Amblyopia. Clin Ophthalmol 2020; 14:1261-1267. [PMID: 32440093 PMCID: PMC7213893 DOI: 10.2147/opth.s234294] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2019] [Accepted: 03/17/2020] [Indexed: 12/01/2022] Open
Abstract
Background Inter-ocular symmetry of macular vascular anatomy in healthy subjects has been well documented in previous optical coherence tomography angiography (OCTA) studies. In our present study, we have demonstrated that the presence of anisometropic amblyopia in one eye does not alter this unique feature significantly. We investigated whether the presence of unilateral anisometropic amblyopia due to moderate amounts of hyperopia and/or astigmatism would have any significant influence on measurements of retinal thickness (RT) and superficial vessel density (SVD) in adult subjects. Subjects and methods In the study group, both eyes of 21 adult subjects with unilateral anisometropic amblyopia were enrolled. Only one eye of an age-matched control group including 33 subjects was randomly selected. RT and SVD were measured in foveal and parafoveal retinal areas and compared in amblyopic eyes, their fellow eyes and in the control group. Inter-ocular symmetry of RT and SVD in amblyopic and fellow eyes were investigated by using correlation analysis. Results There were statistically significant inter-ocular correlations of foveal and parafoveal RT in amblyopic and fellow eyes (P < 0.0001, for both). Foveal and parafoveal RT of the control group were not statistically different from amblyopic eyes (P = 0.072 and P = 0.46, respectively). There was no difference between foveal SVD of amblyopic eyes and control group (P = 0.10) and a significant inter-ocular correlation was found between amblyopic and fellow eyes (P = 0.029). Conclusion For our adult subjects, none of the investigated OCTA parameters of the amblyopic eyes were found to be statistically different from those of age-matched controls. The preservation of inter-ocular symmetry in the amblyopic and fellow eyes implies that the influence of anisometropic amblyopia in one eye would be relatively small and negligible on routine OCTA examination.
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Affiliation(s)
- Zerrin Bayraktar
- Department of Ophthalmology, Ozel Gaziosmanpasa Hospital, Yeni Yuzyil University School of Medicine, Istanbul, Turkey
| | - Seren Pehlivanoglu
- Department of Ophthalmology, Ozel Gaziosmanpasa Hospital, Yeni Yuzyil University School of Medicine, Istanbul, Turkey
| | - Sukru Bayraktar
- Department of Ophthalmology, Ozel Gaziosmanpasa Hospital, Yeni Yuzyil University School of Medicine, Istanbul, Turkey
| | - Sinan Albayrak
- Department of Ophthalmology, Ozel Gaziosmanpasa Hospital, Yeni Yuzyil University School of Medicine, Istanbul, Turkey
| | - Muharrem Karakaya
- Department of Ophthalmology, Ozel Gaziosmanpasa Hospital, Yeni Yuzyil University School of Medicine, Istanbul, Turkey
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Kavitha V, Heralgi MM, Harishkumar PD, Harogoppa S, Shivaswamy HM, Geetha H. Analysis of macular, foveal, and retinal nerve fiber layer thickness in children with unilateral anisometropic amblyopia and their changes following occlusion therapy. Indian J Ophthalmol 2019; 67:1016-1022. [PMID: 31238399 PMCID: PMC6611253 DOI: 10.4103/ijo.ijo_1438_18] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Purpose: To analyze macular thickness (MT), foveal thickness (FT), and retinal nerve fibre layer thickness (RNFLT) in children with unilateral anisometropic amblyopia and their changes following occlusion therapy. Methods: A prospective, longitudinal, and comparative study of 60 children aged between 5 and 18 years consisted of two groups, group 1: 30 children with unilateral anisometropic amblyopia; group 2: 30 normal children. Best corrected visual acuity (BCVA), a detailed ocular examination, spectral domain optical coherence tomography for MT, FT, and RNFLT in both eyes were done at visit one (baseline) and every 3 months for a year following occlusion therapy (initiated one month after first visit) in group 1. Results: Mean BCVA, MT, FT, and RNFLT in amblyopic eyes at first visit were 0.63 ± 0.405, 286.9 ± 6.522 μm, 195.90 ± 8.462 μm, and 100.87 ± 6.240 μm, respectively and at last visit after occlusion therapy were 0.50 ± 0.318, 248.9 ± 11.681 μm, 169.47 ± 10.941 μm, and 99.43 ± 5.722 μm, respectively. At first visit, mean BCVA, MT, FT, and RNFLT in nonamblyopic eyes (group 1) were 0 ± 0, 240 ± 10.447 μm, 159.27 ± 9.285 μm, 98.63 ± 4.723 μm and in normal eyes (group 2: average of right and left eyes) were 0 ± 0, 239.8 ± 4.294 μm, 143.6 ± 4.61 μm, 100.5 ± 2.895 μm, respectively. Conclusion: MT and FT, which were more in amblyopic eyes as compared to normal fellow eyes and group 2, decreased with improvement in BCVA after occlusion therapy. However, there was no difference in RNFLT between amblyopic eyes and normal fellow eyes and group 2 before and after occlusion therapy.
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Affiliation(s)
- V Kavitha
- Consultant, Department of Pediatric Ophthalmology, Sankara Eye Hospital, Harakere, Shimoga, Karnataka, India
| | - Mallikarjun M Heralgi
- Consultant, Department of Cornea and Refractive Services Sankara Eye Hospital, Harakere, Shimoga, Karnataka, India
| | | | - Sneha Harogoppa
- Fellow in Paediatric Ophthalmology, Sankara Eye Hospital, Harakere, Shimoga, Karnataka, India
| | - H M Shivaswamy
- Optometrist, Sankara Eye Hospital, Harakere, Shimoga, Karnataka, India
| | - H Geetha
- School Screening Project Coordinator, Sankara Eye Hospital, Harakere, Shimoga, Karnataka, India
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Pujari A, Chawla R, Mukhija R, Obedulla H, Phuljhele S, Saxena R, Sharma P, Kumar A. Assessment of macular vascular plexus density using optical coherence tomography angiography in cases of strabismic amblyopia. Indian J Ophthalmol 2019; 67:520-521. [PMID: 30900586 PMCID: PMC6446633 DOI: 10.4103/ijo.ijo_1069_18] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Purpose: To evaluate the superficial retinal vascular plexus density using optical coherence tomography angiography (OCTA) in cases of strabismic amblyopia. Methods: Ten eyes of 10 patients with purely strabismic amblyopia underwent detailed ocular evaluation followed by the assessment of the superficial retinal plexus vascular density using OCTA (Topcon DRI OCT Triton, Swept Source OCT, Topcon, Japan). Ten contralateral normal eyes of the same patients were considered as control. All these 20 eyes underwent a 4.5 × 4.5 mm cube scan OCTA centered at the fovea. Using the Topcon propriety software all 20 eyes were assessed for the capillary plexus density of the superficial retinal vascular plexus along the superior, inferior, nasal, and temporal quadrants centered at the fovea. The numerical values were statistically assessed using a paired t-test with respect to each quadrant between the normal and the pathological eyes. Results: The average age of patients was 16 years and eight patients were males. The mean superficial retinal vascular plexus density along the superior, inferior, nasal, and temporal quadrants in normal and pathological eyes were 49.25 ± 30.34 and 48.93 ± 2.85, 47.22 ± 4.11 and 47.37 ± 4.8, 45.54 ± 1.55 and 43.81 ± 4.21, and 46.26 ± 4.63 and 46.38 ± 5.40, respectively. Similarly, the capillary densities along the central were 17.84 ± 3.49 and 17.24 ± 2.44 in normal and pathological eyes. The differences among all these four quadrants and central area were not statistically significant (P-values > 0.05 for all four quadrants and central area) as compared with the normal eyes. Conclusion: The superficial retinal vascular plexus density of a 4.5 × 4.5 mm cube centered at the fovea of eyes of cases of strabismic amblyopia is similar to that of normal eyes.
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Affiliation(s)
- Amar Pujari
- Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
| | - Rohan Chawla
- Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
| | - Ritika Mukhija
- Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
| | - Hameed Obedulla
- Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
| | - Swati Phuljhele
- Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
| | - Rohit Saxena
- Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
| | - Pradeep Sharma
- Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
| | - Atul Kumar
- Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
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Damari B, Mahdavi A, Hajian M. How to improve Iranians' vision health: on the national policy of preventing Iranians' blindness. Int J Ophthalmol 2019; 12:114-122. [PMID: 30662850 DOI: 10.18240/ijo.2019.01.18] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2018] [Accepted: 11/27/2018] [Indexed: 11/23/2022] Open
Abstract
AIM To review vision health situation of Iranian community, analyze its determinants, and discuss the adopted improvement strategies by the Iran Ministry of Health and Medical Education (MOHME). METHODS This was a rapid situation analysis with a qualitative approach in three parts of recognition, orientation and implementation. The data were gathered via review of upstream documents, national and international experiences, and experts and stakeholders' opinions. RESULTS Eradicating trachoma, increasing human resources, increasing educational and research centers and promotion of ophthalmic technologies were important achievements in the field of vision health in Iran. Through these achievements, it seemed that the pattern of causes of blindness and low vision was similar to that of the developed countries. However, the review of Iranians' vision health indicators showed that a considerable percent of the blindness and low vision was avoidable through a national program demanding 3 types of interventions in social determinants of health (SDH), community education, and increasing the access to health care services by integrating the necessary services in primary health care system. CONCLUSION Managing the issue requires attentions from a national committee for preventing blindness with participation of all stakeholders, implementing a national survey on vision health, preparation of the primary level health centers including employment and education of community health workers (Behvarzes), optometrists and general practitioners, fair distribution of specialized human resources and establishing at least one specialized center in each province for referring patients from the primary levels.
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Affiliation(s)
- Behzad Damari
- Neuroscience Institute, Tehran University of Medical Sciences, Tehran 1416833481, Iran
| | - Alireza Mahdavi
- Ministry of Health and Medical Education, Tehran 1467664961, Iran
| | - Maryam Hajian
- Minimally Invasive Surgery Research Center, Iran University of Medical Sciences, Tehran 1445613113, Iran
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Rajavi Z, Sabbaghi H, Behradfar N, Yaseri M, Aghazadeh Amiri M, Faghihi M. Macular Thickness in Moderate to Severe Amblyopia. KOREAN JOURNAL OF OPHTHALMOLOGY 2018; 32:312-318. [PMID: 30091310 PMCID: PMC6085182 DOI: 10.3341/kjo.2017.0101] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2017] [Accepted: 10/31/2017] [Indexed: 01/10/2023] Open
Abstract
PURPOSE To compare the macular retinal thickness of moderately to severely amblyopic eyes with non-amblyopic eyes as controls. METHODS This case control study was conducted on 56 children aged 4 to 10 years old (64.3% female subjects). Twenty-eight children had unilateral amblyopia (28 amblyopic eyes as cases and 28 normal fellow eyes as internal controls) and 28 children had normal visual acuity in both eyes and were considered as external controls (n = 56 eyes). Among our cases, 14 had strabismic amblyopia and 14 had anisometropic amblyopia. Macular retinal thickness was measured using optical coherence tomography at the center and in 1-, 3-, and 6-mm rings. RESULTS Best-corrected visual acuity of the amblyopic eyes was less than that of the internal and external controls, and the best-corrected visual acuity of their fellow eyes was also less than that of the external controls. Thickness of the central macula and a 1-mm ring area in the amblyopic eyes was higher than that of both internal and external controls. Difference of central macular thickness ≥20 μm between two eyes of the amblyopic children was significantly more than non-amblyopic subjects. CONCLUSIONS Based on the results of this study, the macular retinal thickness was significantly higher in moderate to severe amblyopic eyes compared to their fellow eyes and external controls. This might be due to macular developmental disorders in amblyopic eyes. Therefore, optical coherence tomography imaging is recommended if subtle macular abnormalities are suspected in moderate to severe amblyopic eyes.
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Affiliation(s)
- Zhale Rajavi
- Department of Ophthalmology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Hamideh Sabbaghi
- Ophthalmic Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
- Department of Optometry, School of Rehabilitation, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
| | - Narges Behradfar
- Department of Optometry, School of Rehabilitation, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
| | - Mehdi Yaseri
- Department of Biostatistics and Epidemiology, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Aghazadeh Amiri
- Department of Optometry, School of Rehabilitation, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mohammad Faghihi
- Department of Ophthalmology, Torfeh Eye Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Abstract
Introduction: For many years, amblyopia was regarded as a disorder of the visual system in which an organic cause could not be identified. Optical Coherence Tomography opens new horizons in understanding the etiopathology of amblyopia and seems to highlight morphologic anomalies in the retina of the amblyopic eye. Purpose: The objective of this paper is to analyze the macular thickness, optic nerve changes, and choroidal thickness found in patients diagnosed with amblyopia based on trials reported in the literature. Material and methods: This study analyzes 30 clinical trials regarding amblyopia evaluation with Optical Coherence Tomography. The research articles analyzed were published between 2006 - 2016 and were identified on PubMed database. Results: 19 research studies focused on macular and nerve optic changes, 7 on choroidal changes and 6 on retinal changes after occlusion. The results were discussed according to the type of amblyopia, alteration of macular thickness, optic nerve changes, ganglion cell layer changes, and alteration of choroidal thickness. Conclusions: The results are of great variability, and it seems that macula and choroid involvement is more frequently suggested compared with optic nerve involvement. Abbreviations: OCT = Optical Coherence Tomography, RNFL = Retinal Nerve Fiber Layer, GCC = Ganglion Cell Complex, ACD = Anterior Chamber Depth, BCVA = Best Corrected Visual Acuity
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Affiliation(s)
- Elena Avram
- Ophthalmology Department, Medlife Băneasa Hyperclinic, Bucharest, Romania
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Kasem MA, Badawi AE. Changes in macular parameters in different types of amblyopia: optical coherence tomography study. Clin Ophthalmol 2017; 11:1407-1416. [PMID: 28831240 PMCID: PMC5552145 DOI: 10.2147/opth.s143223] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
PURPOSE The purposes of this study were to investigate the changes in macular parameters (thickness, volume) and peripapillary retinal nerve fiber layer (RNFL) thickness (RNFLT) in different cases of amblyopia versus the normal fellow eyes using optical coherence tomography (OCT) and to estimate the relationship of OCT changes with various defined patients' parameters. DESIGN This is a prospective, observational, cross-sectional case series. METHODS The method involved measuring the peripapillary RNFLT, macular thickness, and macular volume via spectral domain (OCT) in different types of amblyopia and comparing with the other fellow eyes. This study was conducted at the Mansoura Ophthalmic Center. RESULTS A total of 64 patients with different types of amblyopia were included. The mean central macular thickness (CMT) was 196.2±50.03 µm in the amblyopic eyes versus 167±12.76 µm in the fellow eyes (P=0.000), the mean average macular thickness was 265.80±12.77 µm in the amblyopic eyes versus 259.10±3.09 µm in the fellow eyes (P=0.000), the mean macular volume was 7.59±0.32 mm3 in the amblyopic eyes versus 7.34±0.071 mm3 in the fellow eyes (P=0.002), and the mean global RNFLT was 97.00±11.60 µm in the amblyopic eyes versus 78.50±13.05 µm in the fellow eyes (P=0.029). There was a discrepancy between the different amblyopic types. Age and the axial length were the only independent variables that statistically significantly correlated with the CMT. CONCLUSION The unilateral amblyopic eyes were prone to have a higher CMT and thicker global RNFL compared to those of the sound fellow eyes. Retinal variations between different types of the amblyopia differ from one type to another. The age could be considered as a predictor of the disease worsening and treatment prognosis. Further studies are required to emphasize these results.
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Affiliation(s)
- Manal Ali Kasem
- Department of Ophthalmology, Faculty of Medicine, Mansoura Ophthalmic Center, Mansoura University, Mansoura, Egypt
| | - Amani E Badawi
- Department of Ophthalmology, Faculty of Medicine, Mansoura Ophthalmic Center, Mansoura University, Mansoura, Egypt
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